他克莫司软膏加口炎清颗粒治疗糜烂型OLP的疗效评价

目的：评价0.03%他克莫司软膏加口炎清颗粒治疗糜烂型口腔扁平苔藓（Oral Lichen Planns,OLP）的临床疗效。方法：80例糜烂型OLP患者,分成观察组和对照组。对照组：0.02%丙酸氯倍他索软膏治疗。观察组：0.03%他克莫司软膏加口炎清颗粒治疗。结果：观察组总有效率为92.50%（37/40）,高于对照组总有效率65.00%（26/40）,具有显著性差异（P〈0.01）。观察组复发率16.21%（6/37）,低于对照组复发率38.46%（10/26）,具有显著性差异（P〈0.05）。两组病例均未出现全身不良反应。结论：0.03%他克莫司软膏加口炎清颗粒治疗糜烂型OLP疗效可靠,复发率低,安全性好。     

他克莫司与雷公藤多甙联合治疗口腔扁平苔藓的临床研究

目的：评价他克莫司与雷公藤多甙联合治疗口腔扁平苔藓（ OLP）的疗效。方法：将纳入研究的89例单纯型OLP患者随机分为3组,分别采用“局部涂抹0．1％他克莫司软膏＋口服雷公藤多甙片”、单纯涂抹0．1％他克莫司软膏、单纯口服雷公藤多甙片的方法治疗4周,在治疗结束时和治疗结束半年后分别进行复查,比较各组疗效。结果：联合应用0．1％他克莫司软膏与雷公藤多甙片治疗OLP显示出满意的短期与长期疗效,统计学差异显著,且不良反应轻微。结论：他克莫司与雷公藤多甙联合治疗口腔扁平苔癣疗效满意。     

0.1%他克莫司软膏治疗老年口腔扁平苔藓疗效观察

目的：比较0.1%他克莫司软膏和0.025%氟轻松软膏对老年口腔扁平苔藓的疗效和安全性。方法：112例老年口腔扁平苔藓分为两组,分别给与0.1%他克莫司软膏（60例）和0.025%氟轻松软膏（52例）每日2次治疗4周,治疗结束时评价疗效和安全性。继续随访4周观察复发情况。结果：他克莫司组痊愈率33.33%,氟轻松组痊愈率15.38%,差异具有统计学意义（P〈0.05）;两组不良反应发生率和复发率比较具有统计学意义（P〈0.05）;糜烂溃疡型组的痊愈率要高于红斑萎缩型和角化过度型（P〈0.05）。结论：0.1%他克莫司软膏治疗老年口腔扁平苔藓比0.025%氟轻松软膏疗效高、复发率低,但是不良反应发生率较高;0.1%他克莫司软膏治疗糜烂溃疡型老年口腔扁平苔藓可获得较高的疗效。     

他克莫司与地塞米松治疗口腔扁平苔藓的短期疗效对比

目的 研究他克莫司溶液和地塞米松溶液对口腔扁平苔藓（OLP）的短期疗效和安全性。方法 60例OLP患者随机分为两组,分别给予0.0015%他克莫司溶液（30例）和0.002%地塞米松溶液（30例）,每日2次含漱及口服治疗4周,治疗结束时评价有效率和不良反应发生率。结果 两组治疗有效率分别为83.3%、63.3%,他克莫司对OLP的短期疗效明显优于地塞米松（X^2=4.36,P = 0.038）,但不良反应的发生率无明显差异（X^2=0.00,P = 0.69）。结论 他克莫司对OLP的短期疗效明显优于地塞米松,值得在临床推广应用,但远期疗效还有待进一步观察研究。     

他克莫司软膏治疗糜烂型口腔扁平苔藓的短期疗效观察

目的评价0.03%他克莫司软膏治疗糜烂型口腔扁平苔藓的短期疗效。方法30例患者分为2组,每组15例,分别用0.03%他克莫司软膏和5%氨来呫诺糊剂治疗4周。按4级疗效标准评定口腔黏膜糜烂充血面积,计算总体疗效。疗效指标为治疗结束时的有效率。结果他克莫司组的总有效率为93.3%,氨来呫诺组的总有效率为66.7%,两者间差异有统计学意义（P〈0.05）。结论他克莫司软膏治疗糜烂型口腔扁平苔藓短期疗效显著。     

他克莫司治疗糜烂型OLP的随机对照双盲试验

目的：评价0．1％他克莫司治疗糜烂型口腔扁平苔癣（OLP）的疗效和安全性。方法：根据相关标准纳入68例糜烂型OLP患者,随机分成两组,双盲法下分别外用0．1％他克莫司和0．05％丙酸氯倍他索治疗,观察和比较两组的总有效率、不良反应发生率及停药6个月后复发率。结果：他克莫司组和丙酸氯倍他索组总有效率分别为97．1％、93．9％,两组间差异无统计学意义（P〉0．05）;两组间复发率分别为6．5％、10．3％,差异无统计学意义（P〉0．05）;两组的局部不良反应发生率均较低且无显著差异（P〉0．05）。结论：局部外用他克莫司在改善OLP患者体征（病损面积）和症状（疼痛）方面效果显著;他克莫司治疗OLP的总有效率、治疗期间局部不良反应发生率及停药后复发率均与糖皮质激素相当。     

他克莫司软膏加口炎清颗粒治疗糜烂型口腔扁平苔藓的短期疗效评价

目的评价0.03%他克莫司软膏加口炎清颗粒治疗糜烂型口腔扁平苔藓患者的疗效。方法 80例糜烂型口腔扁平苔藓患者,试验组和对照组各40例。试验组用0.03%他克莫司软膏加口炎清颗粒治疗,对照组用0.02%丙酸氯倍他索软膏治疗。结果治疗4周后试验组总有效率为92.50%,对照组为65.00%,差异有统计学意义（χ2=9.038,P〈0.05）。试验组和对照组的不良反应率分别为12.50%（5/40）和17.50%（7/40）,差异无统计学意义（χ2=0.392,P〉0.05）。结论 0.03%他克莫司软膏加口炎清颗粒治疗糜烂型口腔扁平苔藓患者短期疗效可靠。     

0．1％他克莫司软膏联合毫米波治疗慢性非特异性唇炎的疗效评价及护理方法

目的：评价0．1％他克莫司软膏（ tacrolimus ointment）联合毫米波（ millimeter wave，MMW）治疗慢性非特异唇炎（ chronic cheilitis，CC）的临床疗效，并探讨相应的护理标准。方法：选择慢性非特异唇炎40例，按治疗方式分为3组，0．1％他克莫司软膏治疗组、毫米波治疗组和0．1％他克莫司软膏治疗与毫米波治疗联合治疗组。严格按照拟定的治疗方案对各组患者进行治疗，7 d为一疗程，在第7 d和第14 d分别评价各组患者的治疗效果。结果：联合组与0．1％他克莫司软膏治疗组疗效均优于毫米波治疗组（P＜0．05），且两者在第14 d疗效并无显著差异。但是在第7 d时，联合治疗组的疗效优于0．1％他克莫司软膏组（P＜0．05），且联合治疗组在第7 d与第14 d的疗效差异无统计学意义。结论：联合使用毫米波虽不能有效提高0．1％他克莫司软膏对于慢性非特应性唇炎的治疗效果，但能缩短治疗时间、减少用量，从而降低0．1％他克莫司软膏的副作用。     

0．03％他克莫司软膏治疗口腔糜烂型扁平苔藓的疗效观察

目的：观察局部应用0．03％他克莫司软膏治疗口腔糜烂型扁平苔藓的疗效。方法：选择口腔糜烂型扁平苔藓患者67例并随机分成两组,分别用0．03％他克莫司软膏和局部注射曲安奈德联合维甲酸治疗。结果：随访观察治疗6个月后显效率及不良反应率,两组差异显著。结论：0．03％他克莫司软膏治疗口腔糜烂型扁平苔藓具有良好的临床疗效。     

他克莫司软膏治疗口腔扁平苔藓的短期疗效评价

目的：观察0．1％他克莫司软膏治疗口腔扁平苔藓的疗效及探讨REU评分系统应用于临床疗效评价的可行性。方法：对56例经病理诊断为1：3腔黏膜扁平苔藓的患者予以0．1％他克莫司软膏治疗4周,采用REU评分系统比较治疗前后临床症状和体征改善情况。结果：他克莫司软膏治疗口腔扁平苔藓总有效率为80．35％,56例患者治疗前REU评分值为（21．98±6．45）,治疗后为（15．03±5．47）,治疗前后评分值差异有统计学意义（P＜0．01）。结论：他克莫司软膏治疗口腔扁平苔藓具有较好的短期疗效,REU评分系统是一种较为客观、精确的临床疗效评     

Comparative effect of tacrolimus 0.1% ointment and clobetasol 0.05% ointment in patients with oral lichen planus

Background: Oral lichen planus (OLP) is considered to be an autoimmune disease of unknown aetiology that affects the mucosae, especially the oral cavity. Objective: We compared tacrolimus 0.1% ointment and clobetasol 0.05% ointment for the treatment of OLP. Patients and Methods: A total of 32 patients (20 females and 12 males; all white, Italian origin, mean age of 43.6±18.4 years; 16 patients per treatment group) were treated with tacrolimus or clobetasol ointment for 4 weeks in a randomized, double‐blind, clinical trial. Pain severity, burning sensation, and mucosal lesion extension were assessed using a four‐point scale. Results: At the end of the treatment period, symptom scores were significantly lower in the tacrolimus group than in the clobetasol group. Conclusion: The results of this study suggest that tacrolimus 0.1% ointment is more effective than clobetasol propionate 0.05% ointment in the treatment of OLP. However, other studies are needed to confirm the effectiveness of this treatment before it can be recommended for use in clinical practice.     

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??Objective    To evaluate the efficacy between low-level diode laser of 810 nm and topical tacrolimus in the treatment of erosive-atrophic oral lichen planus??OLP??. Methods    A total of 60 erosive-atrophic OLP patients were randomly divided into experimental and control groups??with 30 cases in each group. Experimental group received 810 nm diode laser as local irradiation therapy??the control group received drug treatmemt with tacrolimus gel??0.1%??. Evaluations were performed once a month during treatment and at the 3rd month and the 6th month. Results    Sign score??pain score ??and lesion severity were reduced in both groups. No significant differences were found between the two groups. But in the follow-up period after treatment??the recurrence rate of the experimental group was significantly lower than the control group??P < 0.05??. Meanwhile??nine patients of the control group reported side effects after the first one week of drug application. No side effects were found in the experimental group. Conclusion    Diode laser treatment is as effective as topical tacrolimus therapy without any adverse effects in the treatment of erosive -atrophic OLP. Diode laser therapy can reduce recurrence and its post efficacy is superior to tacrolimus. Diode laser therapy can be a promising alternative therapy in the treatment of erosive -atrophic OLP.     

白芍总苷对糜烂型口腔扁平苔藓患者外周血中IFN-γ及IL-10表达的影响研究

目的:探讨白芍总苷对糜烂型口腔扁平苔藓患者外周血中IFN-γ及IL-10表达的影响。方法:选取于2014年2月~2015年3月我院皮肤科与口腔科收治的38例糜烂型口腔扁平苔藓患者为研究对象,随机分为对照组和研究组两组。对照组患者,18例,对照组患者,在清除患者口腔中残根、残冠以及牙石等,用0.1%的他克莫司软膏进行局部治疗,2次/d。研究组患者,20例,在对照组治疗的基础上采用口服白芍总苷胶囊进行治疗,比较两组患者一个疗程后的临床疗效,并采用ELISA法检测并比较治疗前后两组患者外周血中IFN-γ及IL-10的表达情况。结果:对照组,18例,其中有效者2例,好转者6例,无效者10例,总有效率为44.4%。研究组,20例,其中其中有效者8例,好转者7例,无效者5例,总有效率为75%。与对照组相比,研究组患者的总有效率显著升高,差异显著(P＜0.05)。治疗后研究组患者外周血中IFN-γ及IL-10的表达水平均显著升高,差异显著(P＜0.05),具有统计学意义。结论:白芍总苷治疗糜烂型口腔扁平苔藓具有较好的临床疗效,值得临床推广应用。同时,白芍总苷较好的临床疗效可能与其增高了患者外周血中IFN-γ水平及IL-10水平有关。     

生物制剂在口腔扁平苔藓治疗中的应用

口腔扁平苔藓(oral lichen planus,OLP)是一种病因不明、与自身免疫密切相关的慢性炎性疾病.皮质类固醇和免疫抑制剂是治疗OLP的常用药物,但部分OLP患者表现为不敏感或治疗抵抗.有研究提示生物制剂对治疗常规药物治疗不敏感或抵抗的OLP患者显示出优势.该文就治疗OLP生物制剂的种类、机制、疗效、预后及不...     

The onset risk of carcinoma in patients continuing tacrolimus topical treatment for oral lichen planus: a case report

Oral lichen planus is a chronic inflammatory mucocutaneous disease. Topical use of steroids and other immuno-modulating therapies have been tried for this intractable condition. Nowadays, tacrolimus ointment is used more commonly as a choice for treatment. However, a number of discussions have taken place after tacrolimus was reported to be carcinogenic. This report describes a patient who applied tacrolimus ointment to the lower lip after being diagnosed with oral lichen planus in 2008, and whose lesion developed squamous cell carcinoma in 2010. Since the relationship between tacrolimus and cancer development has been reported in only a few cases, including this case report, the clinician must be careful selecting tacrolimus as a second-line treatment for oral lichen planus.     

Oral lichen planus: a retrospective study of 690 British patients

OBJECTIVE: This is the largest UK patient group with oral lichen planus (OLP) to be studied in terms of the demographic and clinical characteristics. MATERIALS AND METHODS: Data were taken from the medical records of 690 consecutive patients referred to Oral Medicine subsequently found to have clinical, and usually histopathological confirmatory features of OLP. Over two-thirds (68.7%) of the patients were Caucasians. RESULTS: Eighty-two per cent of the patients had been referred to a specialist Oral Medicine service by general dental practitioners, 62% of the patients being referred as a consequence of oral mucosal and/or gingival pain. Reticular OLP was the most common intra-oral presentation, but 60% of such lesions were accompanied by other clinical types of OLP. 95% of lesions were bilateral. About 13% of patients reported symptoms or signs, or had a known history of lichen planus or possible lichen planus affecting non-oral epithelia. In only 13% of patients did all signs and symptoms of OLP resolve within 12-246 months (median 35 months). A malignant transformation rate of 1.9% was observed in the present group. CONCLUSIONS: Oral lichen planus in UK persons almost always gives rise to bilateral reticular OLP, rarely resolves spontaneously, and has a low rate of malignant transformation.     

High-level laser therapy versus scalpel surgery in the treatment of oral lichen planus: a randomized control trial

Objective

To compare the clinical effectiveness of various types of high-level laser therapy (HLLT) toward scalpel excision for the surgical treatment of erosive oral lichen planus (OLP).

Materials and methods

The total number of 128 individuals were enrolled in the study. The 35 did not meet the inclusion criteria due to malignancy signs and presence of diabetes mellitus. In total, 8 were lost to follow-up, and 10 were excluded from the analysis, due to analgesics intake. This way 75 patients with the erosive form of OLP were analyzed in three intervention groups (Er:YAG, n = 19; Nd:YAG, n = 15; Er:YAG + Nd:YAG combination, n = 20) and one control group with scalpel excision (n = 21). The therapy effectiveness has been assessed based on the comparison of salivary interleukin (IL)-1β, IL-6 and interferon (IFN)-γ preoperative levels to 14, 30 days, and 2 years postoperation, as well as pain level and time of epithelization.

Results

All HLLT groups demonstrated a significantly (p > 0.05) higher IL-1β, IL-6, IFNγ and pain level reduction and quicker epithelization toward the control group on the 30th day, except Nd:YAG in case of IFNγ level. The highest IL-1β, IFNγ and pain level reduction and quicker epithelization on the 30th day was observed in Er:YAG group, followed by Er:YAG + Nd:YAG combination, Nd:YAG respectively. However no significant difference was observed between the HLLT groups with regard to IL-6 level reduction. After a 2-year follow-up, no significant difference was observed between all study groups with regard to all variables.

Conclusion

HLLT yields a superior clinical outcome compared to the scalpel excision for the surgical treatment of oral lichen planus, whereby the Er:YAG has been proposed as the most effective laser type at the end of the first postoperative month.

Clinical relevance

For the surgical treatment of erosive OLP the Er:YAG laser may be a preferable treatment option compared to Nd:YAG and scalpel surgery.

Trial registration

The present trial was registered retrospectively in the German Clinical Trials Register, as a member of WHO international clinical trials registry platform, on the 18.03.2020 with the following number: DRKS00020986